Orenitram (treprostinil) 1mg

Orenitram is a brand name for treprostinil, a medication used for the treatment of pulmonary arterial hypertension (PAH). It is part of a class of drugs known as prostacyclin analogs and is specifically designed to help improve exercise capacity in patients with PAH. Orenitram is available in oral tablet form, making it a convenient option for patients requiring continuous treatment. This medication represents an important advancement in the management of PAH, offering a prostacyclin pathway therapy that can be taken orally.

How It Works

Treprostinil, the active ingredient in Orenitram, works by mimicking the effects of prostacyclin, a naturally occurring substance in the body that dilates blood vessels and inhibits platelet aggregation. Here’s a detailed explanation of how it works: 1. **Vasodilation**: Treprostinil acts as a potent vasodilator, relaxing the smooth muscles in the walls of blood vessels, particularly in the pulmonary and systemic circulation. This leads to a reduction in pulmonary vascular resistance, decreasing the workload on the right side of the heart. 2. **Inhibition of Platelet Aggregation**: By inhibiting the aggregation of platelets, treprostinil reduces the risk of blood clots forming in the pulmonary arteries, which can worsen PAH. 3. **Improvement of Blood Flow**: Treprostinil improves overall blood flow through the lungs and to the rest of the body, enhancing oxygen delivery and improving exercise capacity in patients with PAH. 4. **Anti-inflammatory Effects**: Treprostinil has anti-inflammatory properties that may contribute to its therapeutic effects by reducing inflammation in the pulmonary vasculature.

Indications

Orenitram is indicated for the treatment of:

• Pulmonary Arterial Hypertension (PAH): It is used to improve exercise capacity in adult patients with WHO Group 1 PAH.

**Note:** Orenitram’s effectiveness may vary based on the underlying cause of PAH, and it is typically used as part of a combination therapy in patients with advanced disease.

Side Effects

Common side effects of Orenitram may include:

• Headache
• Nausea
• Diarrhea
• Flushing
• Jaw pain
• Abdominal pain
• Vomiting
• Edema (swelling of the legs or ankles)
• Dizziness
• Cough

Serious side effects that require immediate medical attention include:

• **Hypotension**: Severe drops in blood pressure can occur, leading to dizziness or fainting.
• **Bleeding**: Due to its anti-platelet effects, treprostinil may increase the risk of bleeding, especially in patients on anticoagulants.
• **Liver Dysfunction**: Elevated liver enzymes may indicate liver injury and require monitoring.
• **Pulmonary Edema**: Patients with certain types of pulmonary venous hypertension may experience worsening symptoms.

Contraindications

Orenitram is contraindicated in the following situations:

• Severe Hepatic Impairment: Treprostinil is contraindicated in patients with severe liver dysfunction (Child-Pugh Class C).
• Known Hypersensitivity: Patients with known hypersensitivity to treprostinil or any of its components should not use Orenitram.
• Acute Pulmonary Edema: Patients with decompensated heart failure due to severe left-sided heart disease should not be treated with Orenitram.
• Concomitant Use with CYP2C8 Inhibitors: Strong inhibitors like gemfibrozil can increase treprostinil exposure, necessitating careful consideration or dosage adjustment.

Pricing Information

Here is a table detailing the price of Orenitram in various countries:

Country	Price (per 1mg tablet)	Reference
United States	$70 – $80	GoodRx
Canada	CAD $90 – $100	DrugBank
United Kingdom	£65 – £75	NHS
Australia	AUD $110 – $120	PBS
Germany	€85 – €95	Apotheken Umschau

Top 5 Global Brands

In addition to Orenitram, several pharmaceutical companies manufacture medications for the treatment of pulmonary arterial hypertension. Here are some of the top global brands:

• Remodulin (treprostinil) – United Therapeutics
• Tyvaso (treprostinil inhalation) – United Therapeutics
• Uptravi (selexipag) – Actelion Pharmaceuticals
• Adempas (riociguat) – Bayer
• Tracleer (bosentan) – Actelion Pharmaceuticals